Laser Therapy May Work on TL IVDD

Laser therapy, the latest modality to enter the marketplace, is taking the veterinary profession by storm.

But veterinary practitioners need to find out how laser helps and which units work before plunging tens of thousands of dollars into underpowered or dubious devices that pale in comparison to similarly priced laser powerhouses.

Facts come from research, and laser therapy currently lacks evidential support in veterinary clinical settings. This calls into question specifics about optimal laser dose and ideal wavelengths. Until studies take place on species treated within our facilities, veterinarians are once again left relying on tissue culture, rodent and human studies.

One application where laser therapy may shine is in patients recovering from thoracolumbar intervertebral disk disease. TL IVDD is the most common spinal cord dysfunction in dogs. 1 Dachshunds outnumber other breeds for the disease by a significant margin; one study showed that dachshunds account for nearly 72 percent of cases. 2 , 3

Compressive spinal cord injury (SCI) causes both primary and secondary tissue damage. The secondary injury phase occurs one to two days after injury and leads to biochemically mediated neuronal death and spinal cord inflammation. 4 Medical intervention yields the best clinical outcomes when treatments address both the primary traumatic and secondary biochemical neuronal injury.

Slow or disappointing recoveries lead to euthanasia in certain circumstances. 5 The degree of improvement in SCI is measured by proprioception, voluntary motor movement, micturition control and deep pain perception. Fuller, quicker neurologic recoveries dissuade clients from opting for euthanasia.

Incomplete recovery means managing an incontinent, paraplegic animal for months to years. If an adjunctive, safe, therapeutic modality afforded an effective means of promoting less painful and faster functional recoveries after surgery for TL IVDD, it could not only decrease morbidity but also reduce mortality.

Conventional Treatments

Methylprednisolone sodium succinate administration had become commonplace for acute compressive SCI, although the human field no longer recognizes MPSS as the standard of care. Research revealed increased costs, longer hospital stays and adverse effects from its use.

Human clinical trials pointed to worsened long-term neurological outcomes in patients who received their first dose of MPSS over eight hours after initial injury. 6 A study published in 2001 confirmed that giving MPSS to dachshunds with surgically treated IVDD linked MPSS with increased post-operative complications (melena, diarrhea, emesis, hematemesis and anorexia) and more costly medical care. 7

Surgical decompression of the spinal cord is instead considered the treatment of choice for dogs with TL IVDD. 8 With surgery, however, come pain and tissue trauma. Surgery precipitates a complex humoral and neuro...